1. Field of the Invention
This invention relates to microsurgery and vascular surgery, and more particularly to a device for use in vessel anastomosis that facilitates vessel approximation and alignment.
2. Description of the Prior Art
In vessel anastomosis, it is necessary to bring the vessel segments to be anastomosed into proximity with each other and to stably maintain the ends of the vessel segments in proper position and alignment so that sutures can be placed. There are no known devices suitable for use in microsurgery that will maintain the vessel segments in the proper position for suturing and that can be easily removed after the sutures are in place.
There are various devices shown in the prior art that could be used as vessel approximators, but each of these devices has serious deficiencies. Among these prior art devices are those shown in the following patents: U.S. Pat. No. 4,483,339, issued to Gillis; U.S. Pat. No. 4,587,969, issued to Gillis; U.S. Pat. No. 4,690,684, issued to McGreevy et al.; U.S. Pat. No. 4,744,364, issued to Kensey; U.S. Pat. No. 4,770,176, issued to McGreevy et al.
One of the problems associated with the design of a suitable vessel approximator is providing means for removing the approximator from the vessels after the vessel segments have been, at least partially, sutured together.
To assist in removal of the approximator, the approximator could be made generally T-shaped so that the ends of the vessel segments can be placed on opposed axially extending portions of the device, and the device can be removed by pulling on the other laterally extending portion of the device. Various T-shaped devices are known for diverse medical uses.
For example, U.S. Pat. No. 3,835,863, issued to Goldberg et al., shows a T-shaped tubular device for insertion into an internal duct for drainage. The drainage device has two laterally extending tubes adapted for insertion in a duct, and a base tube that is used in draining fluid from the duct. The device has a notch formed in the head of the T to facilitate collapse of the two tubes during removal of the device from the duct. This device would not be suitable for anastomosis because the tubes inserted in the duct could not serve the alignment function and because it would be difficult to maintain the device in a stable position in the surgical field during the procedure and because it would be difficult to remove.
Canadian Patent No. 666,090, issued to Sierra Engineering, shows a drainage device similar to that of Goldberg et al. Another T-shaped drainage device is shown in U.S. Pat. No. 4,142,528, issued to Whelan et al.
U.S. Pat. No. 4,230,119, issued to Blum, shows a T-shaped micro-hemostat adapted to be inserted through a slit formed in a vessel. The head of the T has two bars which extend in opposite directions within the vessel. On the end of each bar is a cuff that can be inflated to occlude the vessel.
U.S. Pat. No. 4,168,708, issued to Lepley, shows another T-shaped blood vessel occluder which is used in a manner similar to the device shown in the Blum patent.
In these prior art references, the T-shaped device is usually adapted for insertion into a vessel or duct through a slit. None of the devices are designed for use as an approximation and alignment device in which the ends of the vessel segments would be attached to the device so that the vessel segment ends can be stabilized and positioned for suturing. As such, the devices lack the necessary rigidity and suitability for this purpose. In addition, since none of the prior art devices are adapted for use as an approximation device, none of the prior art devices include means for stabilizing the device and maintaining it in position in the surgical field. Furthermore, many of these devices are not readily adapted for removal from the vessels after the sutures are at least partially in place.